Individual
LAUREN NICOLE MAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PMHNP-BC
Contact information
Practice address
805 N DICKINSON DR, RUSK, TX 75785-1006
(903) 683-3421
(903) 683-7199
Mailing address
PO BOX 318, RUSK, TX 75785-0318
(903) 683-3421
(903) 683-7199
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP142014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
769136
REGISTERED NURSE
TX
01
—
AP142014
PSYCHIATRIC/MENTAL HEALTH NURSE PRACTITIONER
TX
Enumeration date
10/08/2019
Last updated
10/08/2019
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